MEDICARE: ADRIANNA LEIGH FRAZIER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C014224	NC

General Provider Information

NPI Number	:	1306516000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANNA LEIGH FRAZIER LCSW

Provider Business Mailing Address
First Line	:	238 E LEWIS ST STE 401
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-1557
Country	:	US
Telephone Number	:	540-315-5922
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 N MAIN ST STE 210
Second Line	:
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-4003
Country	:	US
Telephone Number	:	336-238-3830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2021
Last Update Date	:	09/15/2021

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